Effect of weight loss and exercise on frailty in obese older adults

Villareal, Dennis T.; Banks, Marian; Sinacore, David R.; Siener, Catherine; Klein, Samuel

doi:10.1001/archinte.166.8.860

Cited by 302Frailty in Older AdultsNutrition and Health in AgingBalance, Gait, and Falls Prevention

Effect of weight loss and exercise on frailty in obese older adults

Villareal, Dennis T., Banks, Marian, Sinacore, David R., Siener, Catherine, Klein, Samuel·2006·Archives of Internal Medicine

DOI 10.1001/archinte.166.8.860

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Abstract

BACKGROUND: Obesity exacerbates the age-related decline in physical function and causes frailty in older persons. However, appropriate treatment for obese older persons is unknown. We evaluated the effects of weight loss and exercise therapy on physical function and body composition in obese older persons. METHODS: We screened 40 obese older volunteers and eventually randomized 27 frail obese older volunteers to treatment or control groups. Treatment consisted of 6 months of weekly behavioral therapy for weight loss in conjunction with exercise training 3 times per week. Physical function was evaluated with measurements of frailty (Physical Performance Test, peak oxygen consumption, and Functional Status Questionnaire); strength, gait, and balance tests; body composition with dual-energy x-ray absorptiometry; and quality of life using the Medical Outcomes Survey 36-Item Short-Form Health Survey. Results are reported as mean +/- SD. RESULTS: Two subjects in the treatment group did not comply with the intervention, and 1 subject in the control group withdrew. Analyses included all 27 subjects originally randomized to the treatment and control groups. The treatment group lost 8.4% +/- 5.6% of body weight, whereas weight did not change in the control group (+0.5% +/- 2.8%; P<.001). Compared with the control group, fat mass decreased (-6.6 +/- 3.4 vs +1.7 +/- 4.1 kg; P<.001), without a change in fat-free mass (-1.2 +/- 2.1 vs -1.0 +/- 3.5 kg; P = .75) in the treatment group. The Physical Performance Test score (2.6 +/- 2.5 vs 0.1 +/- 1.0; P = .001), peak oxygen consumption (1.7 +/- 1.6 vs 0.3 +/- 1.1 mL/min per kilogram; P = .02), and Functional Status Questionnaire score (2.9 +/- 3.7 vs -0.2 +/- 3.9; P = .02) improved in treated subjects compared with control subjects. Treatment also improved strength, walking speed, obstacle course, 1-leg limb stance time, and health survey physical subscale scores (all P<.05). CONCLUSION: These findings suggest that weight loss and exercise can ameliorate frailty in obese older adults. Trial Registration clinicaltrials.gov Identifier: NCT00146133.

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The two key strategies for preserving muscle mass and function during caloric restriction, nutrition and physical exercise, also have beneficial effects on bone, potentially reducing the risk for osteosarcopenic obesity.
“Fortuitously, the two key strategies for preserving muscle mass and function during caloric restriction—nutrition and physical exercise—also have beneficial effects on bone, 105 , 106 , 107 potentially reducing the risk for osteosarcopenic obesity.”
From Strategies for minimizing muscle loss during use of incretin‐mimetic drugs for treatment of obesity (2025) · cites this paper as [106]
Six months of weekly behavioural therapy for weight loss of no more than 10% combined with exercise three times per week, each session lasting 90 min, can improve function and frailty in older obese individuals aged over 65 years.
“Villareal and colleagues125 showed that 6 months of weekly behavioural therapy for weight loss (of no more than 10%) combined with exercise three times per week (each session lasting 90 min) can improve function and frailty in older obese individuals (aged >65 years).”
From Age-related and disease-related muscle loss: The effect of diabetes, obesity, and other diseases (2014) · cites this paper as [125]
Resistance training can improve body composition independent of weight loss.
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From Age-related and disease-related muscle loss: The effect of diabetes, obesity, and other diseases (2014) · cites this paper as [125]
Older adults adhere better to, and maintain greater weight loss from, lifestyle interventions.
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From Obesity pharmacotherapy in older adults: a narrative review of evidence (2025) · cites this paper as [71]

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Authors: Villareal, D. T., Banks, M., Sinacore, D. R., Siener, C., & Klein, S.
Affiliations: Washington University in St. Louis (US)
ORCID: Villareal, Dennis T.
Sinacore, David R.
Klein, Samuel
Venue: Archives of Internal Medicine
Publisher: American Medical Association (AMA)
Published: 2006-04-24
Volume: 166
Issue: 8
Pages: 860
ISSN: 0003-9926 (ISSN-L)
DOI: 10.1001/archinte.166.8.860
OpenAlex: W2108205699
Cited by: 302
References: 52
Citations by year: 2026: 5 · 2025: 11 · 2024: 10 · 2023: 5 · 2022: 10 · 2021: 11 · 2020: 9 · 2019: 11 · 2018: 8 · 2017: 6 · 2016: 17 · 2015: 11 · 2014: 18 · 2013: 28 · 2012: 24
FWCI: 11.41
Type: journal article
Language: en
Open access: closed
Locations: Archives of Internal Medicine (publishedVersion)
PubMed (publishedVersion)
Funders: National Institutes of Health (7r01ag025501-06, RR‐00036, DK56341, AG00078)
National Institute on Aging (AG2116401, AG 00078, AG-025501)
National Institute of Diabetes and Digestive and Kidney Diseases (DK37948, DK56341, R01DK037948, P30DK056341)
National Center for Research Resources (K23RR016191, RR.00036)
Topics: Health Sciences › Medicine › Geriatrics and Gerontology › Frailty in Older Adults
Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Balance, Gait, and Falls Prevention
Keywords: obesity, frailty, older adults, weight loss, exercise training, behavior therapy, physical function, body composition, fat mass, peak oxygen uptake, strength, balance, gait, quality of life
MeSH terms: Activities of Daily Living, Aged, Exercise Therapy, Female, Humans, Male, Obesity, Patient Compliance, Quality of Life, Surveys and Questionnaires, Weight Loss, Exercise, Body Mass Index, Frail Elderly, Treatment Outcome

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Effect of weight loss and exercise on frailty in obese older adults

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